OLDER ADULT NCLEX FINAL PAPER
QUESTIONS AND CORRECT ANSWERS FULL
REVIEW GUIDE
●● The nurse is caring for an 80-year-old patient following right hip
surgery. When administering pain medication to this patient, what is
important for the nurse to remember?
A) Elderly patients have a faster metabolism than their younger
counterparts.
B) Elderly patients have an increased risk for drug toxicity.
C) Elderly patients have a lower incidence of chronic illness.
D) Elderly patients infrequently use OTC medications.
Answer: Answer B. Elderly patients have a sensitivity to medications
and an increased risk for drug toxicity. They have slowed metabolism of
medications, a higher incidence of chronic illness, and an increased use
of prescription and OTC medications.
●● A patient has a pancreatic tumor and history of alcoholism. The
patient receives morphine 2 mg subcutaneously every 3 to 4 hours for
treatment of pain associated with the tumor. After 2 days of receiving
this dose every 4 hours, the patient tells the nurse that the medication is
needed more frequently to control the pain. What is the nurse's best
response to this situation?
,A) The patient is becoming addicted to the morphine, and the
medication should be administered less frequently than every 4 hours.
B) A tolerance to the morphine is developing, and the patient should
receive the drug every 3 hours.
C) Administering the morphine every 3 hours will increase the patient's
physical dependence on the drug.
D) Physical dependence should be avoided at all costs, and the drug
should continue to be administered every 4 hours.
Answer: Answer B. Tolerance occurs when a person who has been
taking opioids becomes less sensitive to their analgesic properties (and
usually side effects). Tolerance is characterized by the need for
increasing doses to maintain the same level of pain relief.
●● A patient who had abdominal surgery 5 days ago complains of sharp,
throbbing abdominal pain that ranks 8 on a scale of 0 (no pain) to 10
(worst pain). The patient's pain rating has averaged at a 3/10 for the first
5 days postoperatively on epidural administration of hydromorphone.
However, narcotic administration via epidural catheter was discontinued
earlier this morning. Which of the following would be the nurse's first
action?
A) Obtain an order to restart the epidural narcotic administration.
B) Assess the patient to rule out possible complications secondary to
surgery.
,C) Check the patient's chart to determine what additional pain
medications can be administered.
D) Explain to the patient that his pain should not be this severe 5 days
postoperatively.
Answer: Answer B. Usually of recent onset and commonly associated
with a specific injury, acute pain indicates that damage or injury has
occurred. Any change in the patient's condition requires an assessment
by the nurse.
●● What instruction should the nurse stress when teaching the
preoperative patient about correct use of the PCA device?
A) Push the button when you feel the pain beginning rather than waiting
until the pain is at its worst.
B) Push the button every 15 minutes whether you feel pain at that time
or not.
C) Instruct your family or visitors to press the button for you when you
are sleeping.
D) Try to go as long as you possibly can before you press the button.
Answer: Answer A. A patient experiencing pain can administer small
amounts of medication directly into the IV, subcutaneous, or epidural
catheter by pressing a button. The pump then delivers a preset amount of
medication. The patient should be instructed to administer medication
before the pain becomes severe.
, ●● When the nurse is gathering a history from a patient newly diagnosed
with glaucoma, the patient reports the following statement to the nurse.
Which statement would be consistent with the patient's diagnosis?
A) "I began seeing halos around lights and had dim vision."
B) "I had a difficult time matching my blue socks."
C) "My eyes began to tear and itch."
D) "I could see the street signs better than my hand."
Answer: Answer A. Blurred vision, halos around lights and difficulty
focusing and adjusting eyes in low lighting, loss of peripheral vision are
classic signs of glaucoma. Glaucoma is related to peripheral vision loss
and blindness, whereas, color is a feature related to central vision. Itchy
and teary eyes are often associated with conjunctivitis. Hyperopia is a
refractive error whereby people have excellent distant vision and near
vision is blurry. Farsightedness is related to the eye having a shorter
depth and, therefore, the visual image focuses beyond the retina.
●● Which statement by the patient diagnosed with viral conjunctivitis
indicates that more teaching is necessary?
A) "I will wash my hands frequently."
B) "I will use a washcloth to clean both my eyes, starting with the
infected eye and moving to the uninfected eye."
C) "I will avoid contact with other people until my symptoms are gone."
QUESTIONS AND CORRECT ANSWERS FULL
REVIEW GUIDE
●● The nurse is caring for an 80-year-old patient following right hip
surgery. When administering pain medication to this patient, what is
important for the nurse to remember?
A) Elderly patients have a faster metabolism than their younger
counterparts.
B) Elderly patients have an increased risk for drug toxicity.
C) Elderly patients have a lower incidence of chronic illness.
D) Elderly patients infrequently use OTC medications.
Answer: Answer B. Elderly patients have a sensitivity to medications
and an increased risk for drug toxicity. They have slowed metabolism of
medications, a higher incidence of chronic illness, and an increased use
of prescription and OTC medications.
●● A patient has a pancreatic tumor and history of alcoholism. The
patient receives morphine 2 mg subcutaneously every 3 to 4 hours for
treatment of pain associated with the tumor. After 2 days of receiving
this dose every 4 hours, the patient tells the nurse that the medication is
needed more frequently to control the pain. What is the nurse's best
response to this situation?
,A) The patient is becoming addicted to the morphine, and the
medication should be administered less frequently than every 4 hours.
B) A tolerance to the morphine is developing, and the patient should
receive the drug every 3 hours.
C) Administering the morphine every 3 hours will increase the patient's
physical dependence on the drug.
D) Physical dependence should be avoided at all costs, and the drug
should continue to be administered every 4 hours.
Answer: Answer B. Tolerance occurs when a person who has been
taking opioids becomes less sensitive to their analgesic properties (and
usually side effects). Tolerance is characterized by the need for
increasing doses to maintain the same level of pain relief.
●● A patient who had abdominal surgery 5 days ago complains of sharp,
throbbing abdominal pain that ranks 8 on a scale of 0 (no pain) to 10
(worst pain). The patient's pain rating has averaged at a 3/10 for the first
5 days postoperatively on epidural administration of hydromorphone.
However, narcotic administration via epidural catheter was discontinued
earlier this morning. Which of the following would be the nurse's first
action?
A) Obtain an order to restart the epidural narcotic administration.
B) Assess the patient to rule out possible complications secondary to
surgery.
,C) Check the patient's chart to determine what additional pain
medications can be administered.
D) Explain to the patient that his pain should not be this severe 5 days
postoperatively.
Answer: Answer B. Usually of recent onset and commonly associated
with a specific injury, acute pain indicates that damage or injury has
occurred. Any change in the patient's condition requires an assessment
by the nurse.
●● What instruction should the nurse stress when teaching the
preoperative patient about correct use of the PCA device?
A) Push the button when you feel the pain beginning rather than waiting
until the pain is at its worst.
B) Push the button every 15 minutes whether you feel pain at that time
or not.
C) Instruct your family or visitors to press the button for you when you
are sleeping.
D) Try to go as long as you possibly can before you press the button.
Answer: Answer A. A patient experiencing pain can administer small
amounts of medication directly into the IV, subcutaneous, or epidural
catheter by pressing a button. The pump then delivers a preset amount of
medication. The patient should be instructed to administer medication
before the pain becomes severe.
, ●● When the nurse is gathering a history from a patient newly diagnosed
with glaucoma, the patient reports the following statement to the nurse.
Which statement would be consistent with the patient's diagnosis?
A) "I began seeing halos around lights and had dim vision."
B) "I had a difficult time matching my blue socks."
C) "My eyes began to tear and itch."
D) "I could see the street signs better than my hand."
Answer: Answer A. Blurred vision, halos around lights and difficulty
focusing and adjusting eyes in low lighting, loss of peripheral vision are
classic signs of glaucoma. Glaucoma is related to peripheral vision loss
and blindness, whereas, color is a feature related to central vision. Itchy
and teary eyes are often associated with conjunctivitis. Hyperopia is a
refractive error whereby people have excellent distant vision and near
vision is blurry. Farsightedness is related to the eye having a shorter
depth and, therefore, the visual image focuses beyond the retina.
●● Which statement by the patient diagnosed with viral conjunctivitis
indicates that more teaching is necessary?
A) "I will wash my hands frequently."
B) "I will use a washcloth to clean both my eyes, starting with the
infected eye and moving to the uninfected eye."
C) "I will avoid contact with other people until my symptoms are gone."
